Individual provider Active NPI

Kieran Donaghey

  • Nurse Practitioner
  • Augusta, ME
National Provider Identifier
1427400043
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN64256 Issued in ME
Practice address
15 Enterprise Dr
Augusta, ME 04330-7997
Phone
(207) 621-8800
Fax
(207) 621-8801
NPI assigned
Jul 7, 2016
Last updated
Jul 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN64256 ME Primary

Addresses

Primary practice location

15 Enterprise Dr
Augusta, ME 04330-7997

Mailing address

15 Enterprise Dr
Augusta, ME 04330-7997
Phone (207) 621-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170928001687 ME Practitioner - Nurse Practitioner 9739453812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

43 Baxter Blvd
Portland, ME 04101-1894
Phone (207) 535-1150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN64256MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Jan 14, 2024 Accepting new patients
Mainegeneral Medical Center CurrentSince Jul 29, 2017 Accepting new patients
Mercy Hospital CurrentSince Jan 14, 2024 Accepting new patients
Mainegeneral Medical Center CurrentSince Jul 29, 2017 Accepting new patients

Locations

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

43 Baxter Blvd
Portland, ME 04101
Phone (207) 775-6381

149 North St
Waterville, ME 04901
Phone (207) 622-1959

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1427400043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307997",
            "telephone_number": "207-621-8800",
            "fax_number": "207-621-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307997",
            "telephone_number": "207-621-8800",
            "fax_number": "207-621-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAGHEY",
        "first_name": "KIERAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "RN64256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.